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Biomedical subjects

B K Rimer

Publications and source records attributed to B K Rimer.

At least 91 records · Page 5Linked to original sources
PubMed1993

Improving the use of cancer screening for older women.

Breast cancer is a serious disease in terms of incidence and mortality for older women. Older women are likely to receive substantial benefit from mammography because of their increased risk for the disease. However, most women older than 65 years are not getting regular mammograms. There are a number of barriers to breast screening for older women, but perhaps none is more important than the lack of a physician recommendation. Tailored programs are needed if the promise of breast cancer screening is to be realized for older women. Such programs should reflect the heterogeneity of older women. In addition, physicians must be collaborators because of their central role influence.

Aged↗
PubMed1993

Characteristics of men reporting for prostate cancer screening.

A survey to determine demographics, prostate cancer screening practices, and prostate cancer-related knowledge and beliefs was administered to over 1,700 participants at five sites during Prostate Cancer Awareness Week (1991) screening events. Findings are presented by site since significant differences in demographics existed. Results suggest that screenings conducted at the major medical centers attract primarily white males, a number of whom already practice adequate secondary prevention. Thus, if optimal benefit is sought through mass prostate cancer screening, innovative strategies to reach populations that are currently underserved and at risk are necessary.

Adult↗
PubMed1993

Impact of patient-controlled compression on the mammography experience.

The authors tested the hypothesis that giving women control over the compression portion of the mammography examination results in a less painful experience, greater overall patient satisfaction, and a radiographic image as good as that produced by means of technologist-controlled compression. One hundred nine women undergoing screening mammography at a hospital-based outpatient clinic were studied. Each underwent two-view, screen-film mammography performed in routine fashion except that, by random assignment, one breast was compressed by the technologist and the other breast, by the patient. Patient-controlled compression was significantly (P = .003) less painful than technologist-controlled compression. Overall patient satisfaction (96% [105 of 109]) and willingness to repeat the experience were extremely high. The majority of images (93.5% [202 of 216]) were rated as having good to excellent compression. With minimal patient education, self-compression resulted in an image at least as good as that produced with technologist-applied compression. Further study of this technique is warranted.

Adult↗
PubMed1993

Mammography-related beliefs of older women. A survey of an HMO population.

Although breast cancer risk increases with age, most studies show that mammography use decreases. A 15-minute telephone survey of 548 women health maintenance organization (HMO) members aged 65 to 74 who had not obtained a mammogram within the past year was undertaken to identify sociodemographic factors as well as knowledge, belief, and attitudinal characteristics associated with mammography history. Women who had never had a mammogram were less likely to have received a physician's recommendation and more likely to express negative attitudes about mammography, such as having a mammogram means "looking for trouble" and "makes me nervous." In addition, they expressed doubts about their need to have a mammogram and reported that "other problems" prevented them from having a mammogram. These results suggest that women who have never had a mammogram may require more intensive interventions to encourage them to obtain mammograms. In addition to receiving a mammography recommendation from their physicians, they might benefit from individual or small group educational sessions where negative attitudes about mammography could be explored and modified.

Attitude to Health↗
PubMed1993

Why women gain weight with adjuvant chemotherapy for breast cancer.

PURPOSE: Among breast cancer patients receiving adjuvant chemotherapy, weight gain is a common side effect that may decrease quality of life and potentially threaten survival. Weight gain during treatment is a problem that is clinically well appreciated, and one that has been studied by a number of investigators. DESIGN: A literature review was conducted to address each of the following issues: (1) the prevalence and magnitude of weight gain in women receiving adjuvant chemotherapy for early-stage breast cancer, (2) factors that might affect the amount of weight gained, (3) adverse consequences of weight gain, (4) mechanisms potentially responsible for weight gain, and (5) current dietary intervention programs directed toward women receiving adjuvant chemotherapy. RESULTS: Weight gain is associated with a number of adverse effects in breast cancer patients receiving adjuvant chemotherapy. Weight gains are exaggerated in premenopausal women and women receiving multiagent regimens. Little research has been conducted to investigate the underlying mechanisms that contribute to weight gain in this population. CONCLUSION: Interventions to prevent weight gain during adjuvant chemotherapy are underway; however, little research has been conducted to investigate the underlying mechanisms of energy imbalance. Although changes in resting metabolic rate, thermogenesis, physical activity, and dietary intake are all plausible, no firm data exist to support any of these mechanisms. There is a need for research that explores the relative contribution of each of these factors to energy imbalance, so that optimally effective interventions can be created and implemented to combat this problem.

Breast Neoplasms↗
PubMed1993

Results of an antismoking media campaign utilizing the Cancer Information Service.

In this paper, results are presented on the response to an antismoking media campaign designed to encourage women cigarette smokers with young children to call for information on quitting. The intervention campaign used a mix of professionally produced broadcast and print materials that encouraged smokers to call the National Cancer Institute's Cancer Information Service (CIS) for information on quitting. The campaign was implemented in seven media markets in New York state, Pennsylvania, and Delaware; each of these markets was paired with a control market in one of the three states. Response to the campaign was gauged by monitoring calls to the New York and Pennsylvania area CIS offices from smokers residing in intervention and control media markets. Results from the 46-week campaign show that the number of calls for smoking-cessation information was five times greater from intervention markets than from control markets. The campaign also was successful in reaching the target audience of mothers of young children. Twenty-nine percent of calls received from intervention markets were from the target audience compared with 10% from the control markets. Forty-four percent of all calls received from intervention markets came during a 5-week period when time was purchased to air television spots.

Adult↗
PubMed1993

Older callers to the Cancer Information Service.

Cancer incidence and mortality are disproportionately high in older adults, yet most public service campaigns have not been directed explicitly at this population. We analyzed Cancer Information Service (CIS) call data from the years 1983-1990 to characterize callers age 60 years and over. Of 1,091,809 calls from which the age of the caller was ascertained, 206,104 (19%) were from this age group. Most older callers learned of the CIS from the telephone book, television, and brochures or pamphlets. In addition, we examined calls specifically from 1990 to ascertain recent trends in CIS utilization. Comparisons also were made between callers 60 and older and those 40-59. Additional targeting could increase calls from older adults.

Adult↗
PubMed1993

Psychosocial impact of cancer screening.

Cancer screening programs, including tests for early detection and programs aimed at identifying people with carcinogenic occupational exposure, may have psychological and behavioral sequelae. An abnormal screening result can lead to distress and anxiety that may continue even after further workup rules out cancer. Such psychological distress can affect subsequent health behavior. When testing or counseling indicates risk factors for cancer, the individual generally tries to adhere to the recommended preventive guidelines. A moderate amount of anxiety about the results may even be a motivating factor in getting subsequent check-ups. However, in some cases such knowledge leads to extreme levels of distress that can actually interfere with adherence behavior. Intervention studies now suggest that simple strategies can successfully reduce screening-related anxiety. Such interventions are particularly important to assure that people with positive tests do not drop out of the system for future screening.

Anxiety↗
PubMed1992

Participant enrollment, participation, and compliance in chemoprevention trials.

Chemoprevention trials offer exciting opportunities for decreasing the risk for cancer. Close attention to the recruitment, enrollment, and compliance of participants will aid greatly in both the cooperation of participants and the long-term adherence that are essential for the success of these trials.

Anticarcinogenic Agents↗
PubMed1992

The role of patient education in cancer pain control.

Patient education should be a central component of pain control regimens for cancer patients. Few systematically developed and carefully evaluated pain control patient education programs have been reported. Patient education for cancer pain control should include five phases: assessment, goal setting, selection of educational strategies, implementation and reassessment. Each of these phases should be included to maximize the goals of pain prevention and pain relief.

Humans↗
PubMed1992

Factors associated with adherence to breast cancer screening among working women.

This study identified sociodemographic, knowledge, attitude, and social influence correlates of obtaining mammograms among employed women age 40 and over. Telephone interviews were conducted with 798 women who worked at 39 different work sites. Eighty-four percent of respondents had ever had a mammogram, and 72% had had one at the recommended interval for their age group. The only personal characteristic that was associated with past mammography use was having a co-worker, friend, or relative with a history of breast cancer. Logistic regression analyses indicated that a doctor's advice to have a mammogram, knowledge of screening guidelines, knowing someone with breast cancer, and the beliefs that mammography is effective and that mammography is necessary in the absence of symptoms were associated independently with past use of mammography. Three factors contributed independently to explaining adherence to mammography guidelines: younger age, knowledge of guidelines for one's own age group, and the belief that breast cancer is curable. The findings suggest that emphasizing the recommended guidelines, the need for and benefits of mammography in educational programs, and offering low-cost or free mammography at the workplace, can further increase appropriate utilization among working women.

Age Factors↗
PubMed1992

The impact of tailored self-help smoking cessation guides on young mothers.

It has been suggested that tailoring self-help materials for specific target populations will increase their effectiveness. This study tested the value of a self-help guide tailored specifically for women with young children. These women were recruited through a media campaign that encouraged smokers to call the Cancer Information Service (CIS) for assistance in stopping smoking. Women smokers with young children (under the age of 6) who called the CIS were given telephone counseling on quitting and were mailed one of three stop smoking guides. One third of callers received Quitting Times, a guide written specifically for women with young children; one third received the American Lung Association guide, Freedom from Smoking for You and Your Family; and one third received Clearing the Air, a guide developed by the National Cancer Institute. Six months after calling the CIS, these women were contacted by telephone to assess changes in smoking behavior. Overall, 12.5% of the women reported not smoking for at least 1 week at the time of the 6-month follow-up interview. There were no significant differences between subjects in the three groups in use of the self-help guides, methods used to attempt quitting, and quitting behavior. Findings from this study do not support the hypothesis that using a tailored stop smoking guide increases the targeted audience's cessation rate or affects quitting-related behavior. However, it should be noted that the smokers who called were predominantly in the contemplation or action stages.

Adult↗
PubMed1992

Older women's participation in breast screening.

The incidence of breast cancer increases with age, but women's participation in breast screening decreases with age. National and regional surveys indicate a number of barriers. Women over age 65 are more likely to say they have never heard of mammograms, that they did not know they needed them, and that their doctors did not recommend them. In a study conducted at Fox Chase Cancer Center, in Philadelphia, participation in an HMO-sponsored breast screening program appeared to reverse the usual age-related decrease in mammography. If mammography utilization is to increase in women over age 65, physicians must offer unambiguous referrals to older women. In addition, health education interventions are needed to improve knowledge and beliefs of older women and their physicians. And, finally, strategies also are needed to enhance access. With the advent of Medicare coverage, payment will be less of a barrier. But other barriers remain.

Aged↗
PubMed1991

Psychological and behavioral implications of abnormal mammograms.

OBJECTIVE: To evaluate women's psychological responses to abnormal mammograms and the effect on mammography adherence. To identify psychological responses and other factors that predict mammography adherence in women with normal or abnormal mammograms. DESIGN: Survey study with prospective analysis of factors associated with mammography adherence. SETTING: Health Maintenance Organization of Pennsylvania and New Jersey (HMO PA/NJ). PATIENTS: Study patients, members of HMO PA/NJ who were 50 years of age or older, and who had had mammography done 3 months earlier, included women with normal mammograms (n = 121), women with low-suspicion mammograms (n = 119), and women with high-suspicion mammograms (n = 68), but not women with breast cancer. MEASUREMENTS: Psychological responses 3 months after mammography and adherence to subsequent annual mammography were assessed. MAIN RESULTS: Women with high-suspicion mammograms had substantial mammography-related anxiety (47%) and worries about breast cancer (41%). Such worries affected the moods (26%) and daily functioning (17%) of these women, despite diagnostic evaluation excluding malignancy. For each variable, a consistent trend (P greater than 0.05) was seen with degree of mammogram abnormality. Sixty-eight percent of women with normal results, 78% of women with low-suspicion results, and 74% of women with high-suspicion results obtained their subsequent annual mammograms (P greater than 0.05). The number of previous mammograms (odds ratio, 3.2; 95% CI, 1.6 to 6.2) and the effect of the previous results on concerns about breast cancer (odds ratio, 0.5; CI, 0.2 to 1.0) were independent predictors of adherence in logistic regression analyses (P less than 0.05). CONCLUSIONS: A substantial proportion of women with suspicious mammograms have psychological difficulties, even after learning that they do not have cancer. Such sequelae do not appear to interfere with subsequent adherence.

Aged↗